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Vanlaer Y, Minschart C, Vrolijk H, Van Crombrugge P, Moyson C, Verhaeghe J, Devlieger R, Vandeginste S, Verlaenen H, Vercammen C, Maes T, Dufraimont E, Roggen N, De Block C, Jacquemyn Y, Mekahli F, De Clippel K, Van Den Bruel A, Loccufier A, Van Pottelbergh I, Myngheer N, Abrams P, Vinck W, Leuridan L, Driessens S, Billen J, Matthys C, Bogaerts A, Laenen A, Mathieu C, Benhalima K. Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes. Front Endocrinol (Lausanne) 2024; 15:1374682. [PMID: 38933819 PMCID: PMC11199774 DOI: 10.3389/fendo.2024.1374682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
Aims To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes. Methods Sub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI. Results Of all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5-1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4-1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group. Conclusions Breastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.
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Affiliation(s)
- Yana Vanlaer
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Caro Minschart
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | | | - Paul Van Crombrugge
- Department of Endocrinology, OLV Ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Carolien Moyson
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Johan Verhaeghe
- Department of Obstetrics & Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Roland Devlieger
- Department of Obstetrics & Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
- REALIFE Research Group, Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, GZA Hospitals Sint-Augustinus, Antwerp, Belgium
| | - Sofie Vandeginste
- Department of Obstetrics & Gynecology, OLV Ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Hilde Verlaenen
- Department of Obstetrics & Gynecology, OLV Ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Chris Vercammen
- Department of Endocrinology, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Toon Maes
- Department of Endocrinology, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Els Dufraimont
- Department of Obstetrics & Gynecology, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Nele Roggen
- Department of Obstetrics & Gynecology, Imelda Ziekenhuis, Bonheiden, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Edegem, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics & Gynecology, Antwerp University Hospital, Edegem, Belgium
- ASTARC and GHI, Antwerp University, Antwerp, Belgium
| | - Farah Mekahli
- Department of Endocrinology, Kliniek St-Jan Brussel, Brussel, Belgium
| | - Katrien De Clippel
- Department of Obstetrics & Gynecology, Kliniek St-Jan Brussel, Brussel, Belgium
| | | | - Anne Loccufier
- Department of Obstetrics & Gynecology, AZ St Jan Brugge, Brugge, Belgium
| | | | - Nele Myngheer
- Department of Endocrinology, General Hospital Groeninge Kortrijk, Kortrijk, Belgium
| | - Pascale Abrams
- Department of Endocrinology, ZAS Hospital Sint-Vincentius, Antwerpen, Belgium
- Department of Endocrinology, ZAS Hospital Sint-Augustinus, Antwerpen, Belgium
| | - Wouter Vinck
- Department of Endocrinology, ZAS Hospital Sint-Augustinus, Antwerpen, Belgium
| | - Liesbeth Leuridan
- Department of Endocrinology, General Hospital Klina, Brasschaat, Belgium
| | - Sabien Driessens
- Department of Endocrinology, General Hospital Klina, Brasschaat, Belgium
| | - Jaak Billen
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Christophe Matthys
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Annick Bogaerts
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Faculty of Health, University of Plymouth, Plymouth, Devon, United Kingdom
| | - Annouschka Laenen
- Center of Biostatics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Katrien Benhalima
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
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Hulsbosch LP, Nyklíček I, Boekhorst MG, Potharst ES, Pop VJ. Breastfeeding continuation is associated with trait mindfulness but not with trajectories of postpartum depressive symptoms. Midwifery 2023; 124:103770. [PMID: 37419008 DOI: 10.1016/j.midw.2023.103770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis. DESIGN, SETTING AND PARTICIPANTS The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands. MEASUREMENTS A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months. FINDINGS Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p = .002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p = .735), adjusted for confounders. KEY CONCLUSIONS This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation. IMPLICATIONS FOR PRACTICE Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable.
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Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Myrthe Gbm Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Eva S Potharst
- UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Victor Jm Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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Muro-Valdez JC, Meza-Rios A, Aguilar-Uscanga BR, Lopez-Roa RI, Medina-Díaz E, Franco-Torres EM, Zepeda-Morales ASM. Breastfeeding-Related Health Benefits in Children and Mothers: Vital Organs Perspective. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1535. [PMID: 37763654 PMCID: PMC10536202 DOI: 10.3390/medicina59091535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023]
Abstract
Breast milk (BM) is a constantly changing fluid that represents the primary source of nutrition for newborns. It is widely recognized that breastfeeding provides benefits for both the child and the mother, including a lower risk of ovarian and breast cancer, type 2 diabetes mellitus, decreased blood pressure, and more. In infants, breastfeeding has been correlated with a lower risk of infectious diseases, obesity, lower blood pressure, and decreased incidence of respiratory infections, diabetes, and asthma. Various factors, such as the baby's sex, the health status of the mother and child, the mother's diet, and the mode of delivery, can affect the composition of breast milk. This review focuses on the biological impact of the nutrients in BM on the development and functionality of vital organs to promote the benefit of health.
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Affiliation(s)
- Julio César Muro-Valdez
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Alejandra Meza-Rios
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
| | - Blanca Rosa Aguilar-Uscanga
- Laboratorio de Microbiología Industrial, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Rocio Ivette Lopez-Roa
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Eunice Medina-Díaz
- Instituto Transdisciplinar de Investigación y Servicios, CUCEI, Universidad de Guadalajara, Av. José Parres Arias 5, Rinconada de la Azalea, Industrial Belenes, Zapopan 45150, Mexico
| | - Esmeralda Marisol Franco-Torres
- Laboratorio de Investigación y Desarrollo Farmacéutico, Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico
| | - Adelaida Sara Minia Zepeda-Morales
- Laboratorio de Análisis Clínicos y Bacteriológicos (Vinculación), Departamento de Farmacobiología, CUCEI, Universidad de Guadalajara, Boulevard Marcelino García Barragán, No. 1421, Guadalajara 44430, Mexico; (J.C.M.-V.); (A.M.-R.)
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Impact of autonomic regulation on burnout and performance in thoracic surgery residents. JTCVS OPEN 2022; 11:229-240. [PMID: 36172445 PMCID: PMC9510830 DOI: 10.1016/j.xjon.2022.04.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/03/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022]
Abstract
Objective This study sought to determine the feasibility of collecting physiologic data in thoracic surgery residents and whether it would correlate with burnout and burnout with performance. Methods This was a prospective study of thoracic surgery residents over a 5-month period. Participants were evaluated with a wearable biometric device (heart rate variability and sleep) and the Maslach Burnout Inventory. Resident performance was quantified using Accreditation Council for Graduate Medical Education Milestones (scale, 1-5) normalized to program-designated targets (3 for postgraduate year 6 or lower residents and 4 for postgraduate year 7 residents). Results The cohort consisted of 71% female participants (5/7) with 86% of residents having 1 or more children. High levels of emotional exhaustion (median, 30 [interquartile range, 20-36], where >26 is high) and high levels of depersonalization (median, 16 [interquartile range, 14-22], where >12 is high) were common, but personal accomplishment was also uniformly high (median, 43 [interquartile range, 41-46], where >38 is high). There was a significant correlation between heart rate variability and emotional exhaustion (r(12) = 0.65, P = .01) but not depersonalization (P = .28) or personal accomplishment (P = .24). Depersonalization and personal accomplishment did not correlate with resident performance (P = .12 and P = .75, respectively); however, increased emotional exhaustion showed a significant correlation with higher resident performance during periods when burnout was reported (r(6) = 0.76, P = .047). Conclusions Dynamic measurement of resting heart rate variability may offer an objective measure of burnout in thoracic surgery residents. Thoracic surgery residents who report high levels of burnout in this cohort maintained the ability to meet program-designated milestones at or above the level expected of their postgraduate year.
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Sukmanee J, Rothmanee P, Sriwimol W, Staff A, Liabsuetrakul T. Levels of blood pressure, cardiovascular biomarkers and their correlations in women with previous pre-eclamptic pregnancy within 7 years postpartum: a cross-sectional study in Thailand. BMJ Open 2022; 12:e055534. [PMID: 35705351 PMCID: PMC9204415 DOI: 10.1136/bmjopen-2021-055534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the levels of blood pressure, cardiovascular biomarkers and their correlations measured within 7 years postpartum in women with previous pre-eclamptic pregnancies compared with women with previous normotensive pregnancies. DESIGN Cross-sectional study. SETTING Two tertiary hospitals in the southern region of Thailand. PARTICIPANTS Women with pre-eclamptic and normotensive pregnancies in the past 7 years were enrolled from 1 October 2019 to 30 April 2021. Eligible women were interviewed, examined for body mass index (BMI) and blood pressure, and donated morning spot urine and blood samples. PRIMARY OUTCOME MEASURES Serum high-sensitivity C reactive protein, creatinine, fasting blood glucose (FBS), glycated haemoglobin (HbA1c), low-density lipoprotein (LDL) cholesterol, urine microalbumin to creatinine ratio (UACR) and sodium were measured. Group differences in biomarkers were tested using unpaired t-test, Wilcoxon rank-sum test or χ2 test. The levels of blood pressure and biomarkers between the two study groups at <2 years, 2-4 years and >4 years were also compared. The correlations between blood pressure and biomarkers were analysed using Pearson's correlation and partial correlation methods. RESULTS From 206 women included in the analysis, 88 had pre-eclamptic pregnancies and 118 had normotensive pregnancies. Compared with women with previous normotensive pregnancies, women with previous pre-eclamptic pregnancies had significantly increased rates of hypertension (31.8% vs 7.6%, p<0.001) and obesity (55.7% vs 40.7%, p=0.038), as well as higher serum levels of FBS (p<0.001), HbA1c (p<0.001), LDL cholesterol (p=0.03), creatinine (p<0.001) and UACR (p<0.001). Correlation coefficients of BMI, serum creatinine and UACR with blood pressure ranged from 0.27 to 0.31. CONCLUSION The risk of hypertension after a pre-eclamptic pregnancy increased. Blood pressure measurement combined with BMI, serum creatinine and UACR screening at least once during 7 years postpartum is suggested for early detection of cardiovascular risk.
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Affiliation(s)
- Jarawee Sukmanee
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Penkae Rothmanee
- Division of Obstetrics and Gynecology, Naradhiwas Rajanagarindra Hospital, Narathiwat, Thailand
| | - Wilaiwan Sriwimol
- Department of Pathology, Prince of Songkla University, Hat Yai, Thailand
| | - Annetine Staff
- Division of Obstetrics and Gynaecology, Faculty of Medicine, Oslo University Hospital, Oslo, Norway
| | - Tippawan Liabsuetrakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Breastfeeding intention and trait mindfulness during pregnancy. Midwifery 2021; 101:103064. [PMID: 34161916 DOI: 10.1016/j.midw.2021.103064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Breastfeeding has been associated with many health benefits for both infant and mother. Trait mindfulness during pregnancy may have a beneficial impact on breastfeeding intention. The current study aimed to examine whether trait mindfulness during pregnancy was associated with antenatal breastfeeding intention. DESIGN, SETTING AND PARTICIPANTS The current study is part of a large prospective population-based cohort study among pregnant women in the south of the Netherlands. MEASUREMENTS A subsample of participants completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy and a question on their breastfeeding intention at 32 weeks of pregnancy (N=790). Moreover, the Edinburgh Depression Scale and Tilburg Pregnancy Distress scale were completed at 32 weeks of pregnancy to assess levels of distress. FINDINGS Univariate analyses showed that women with breastfeeding intention during pregnancy had significantly higher scores on the mindfulness facet non-reacting (p<.001, medium effect size) and significantly lower scores on acting with awareness (p=.035, small effect size). A subsequent multiple logistic regression analysis showed that only non-reacting remained significantly associated with antenatal breastfeeding intention (OR=1.09, 95% CI [1.03, 1.15], p=.001), after controlling for confounders. Women who eventually initiated breastfeeding had significantly higher non-reacting scores (p<.001, small to medium effect size). KEY CONCLUSIONS The mindfulness facet non-reacting was found to be associated with antenatal breastfeeding intention. More research is needed to confirm our results, since the current study is one of the first assessing the possible relation of trait mindfulness during pregnancy and breastfeeding intention. IMPLICATIONS FOR PRACTICE Mindfulness-based programs during pregnancy could be helpful in improving non-reacting in pregnant women, which may enhance breastfeeding intention and ultimately the initiation of breastfeeding.
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Bester M, Moors S, Joshi R, Nichting TJ, van der Hout-van der Jagt MB, Oei SG, Mischi M, Vullings R, van Laar JOEH. Changes in Maternal Heart Rate Variability in Response to the Administration of Routine Obstetric Medication in Hospitalized Patients: Study Protocol for a Cohort Study (MAMA-Heart Study). Clin Pract 2021; 11:13-25. [PMID: 33599215 PMCID: PMC7838947 DOI: 10.3390/clinpract11010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 12/05/2022] Open
Abstract
Pregnancy is a period of continuous change in the maternal cardiovascular system, partly mediated by the autonomic nervous system. Insufficient autonomic adaptation to increasing gestation is associated with pregnancy complications, such as hypertensive disorders of pregnancy and preterm birth (both major causes of perinatal morbidity and mortality). Consequently, maternal heart rate variability (mHRV), which is a proxy measure for autonomic activity, is increasingly assessed in these cohorts to investigate the pathophysiology of their complications. A better pathophysiological understanding could facilitate the early detection of these complications, which remains challenging. However, such studies (typically performed in pregnancies leading to hospitalization) have generated conflicting findings. A probable reason for these conflicting findings is that these study cohorts were likely administered routine obstetric medications during the study period of which the effects on mHRV are largely unknown. Subsequently, we design a longitudinal, observational study to quantifying the effect of these medications-particularly corticosteroids, which are known to affect fetal HRV-on mHRV to improve the interpretation of past and future studies. We will enroll 61 women admitted to a tertiary obstetric unit with an indication to receive corticosteroids antenatally. Participants' mHRV will be continuously acquired throughout their hospitalization with wrist-worn photoplethysmography to facilitate a within-patient comparison of the effect of corticosteroids on mHRV.
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Affiliation(s)
- Maretha Bester
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Family Care Solutions, Philips Research, 5656 AE Eindhoven, The Netherlands;
| | - Suzanne Moors
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Obstetrics and Gynecology, Máxima MC, 5504 DB Veldhoven, The Netherlands
| | - Rohan Joshi
- Department of Family Care Solutions, Philips Research, 5656 AE Eindhoven, The Netherlands;
| | - Thomas J. Nichting
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Obstetrics and Gynecology, Máxima MC, 5504 DB Veldhoven, The Netherlands
| | - M. Beatrijs van der Hout-van der Jagt
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Obstetrics and Gynecology, Máxima MC, 5504 DB Veldhoven, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands
| | - S. Guid Oei
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Obstetrics and Gynecology, Máxima MC, 5504 DB Veldhoven, The Netherlands
| | - Massimo Mischi
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
| | - Judith O. E. H. van Laar
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands; (S.M.); (T.J.N.); (M.B.v.d.H.-v.d.J.); (S.G.O.); (M.M.); (R.V.); (J.O.E.H.v.L.)
- Department of Obstetrics and Gynecology, Máxima MC, 5504 DB Veldhoven, The Netherlands
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Vila-Candel R, Soriano-Vidal FJ, Mena-Tudela D, Quesada JA, Castro-Sánchez E. Health literacy of pregnant women and duration of breastfeeding maintenance: A feasibility study. J Adv Nurs 2020; 77:703-714. [PMID: 33210369 DOI: 10.1111/jan.14625] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 10/27/2020] [Indexed: 12/20/2022]
Abstract
AIMS Research the association between health literacy (HL) and exclusive breastfeeding at 4-months postpartum. BACKGROUND Despite the benefits of breastfeeding (BF), its rates are low worldwide. Among the reasons for abandonment is the level of maternal education. Maternal education has been associated with HL, but evidence between HL and BF maintenance is limited. DESIGN A cross-sectional study. METHODS The sample compromised 229 nursing mothers recruited from January 2018 to the end of December 2018 at Spain by systematic sampling method. Women were interviewed postpartum on parameters associated with the start and continuation of BF up to 4 months postpartum. Multivariate logistic regression models to explain exposure variables and exclusive BF cessation at 4 months. RESULTS Approximately 10% of the participants had inadequate HL. Factors associated with early cessation of exclusive BF at 4 months in the multivariate model adjusted using a stepwise variable selection process based on a likelihood ratio test were civil status, risk of pregnancy, type of delivery, limited or inadequate level of HL, and LATCH score at discharge, with an 85.6% area under the ROC curve. CONCLUSIONS Our study offers preliminary evidence regarding the hitherto inconsistent relation between HL and early cessation exclusive BF at 4 months, supporting the conduct of further studies with larger sample sizes and greater statistical power. Such studies are warranted before endorsing HL-based interventions aiming to mitigate early cessation exclusive BF. IMPACT Low or inadequate HL is linked to multiple poor health and clinical outcomes. We investigated the prevalence of exclusive BF at 4 months postpartum, and the impact of HL in maintaining optimal exclusive BF practices. Limited or inadequate HL was one of the factors associated with early cessation of exclusive BF in the multivariate regression model, although further research is needed.
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Affiliation(s)
- Rafa Vila-Candel
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Valencia, Spain.,Department of Nursing, Universitat de València, Valencia, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, Valencia, Spain.,Department of Nursing, University of Alicante, Alicante, Spain.,Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, Xàtiva, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I. Av de Vicent Sos Baynat, Castelló, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, Elche, Alicante, Spain
| | - Enrique Castro-Sánchez
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU), Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK.,School of Health Sciences, City, University of London, London, UK
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Moe K, Sugulle M, Dechend R, Angel K, Staff AC. Functional and structural vascular biomarkers in women 1 year after a hypertensive disorder of pregnancy. Pregnancy Hypertens 2020; 21:23-29. [DOI: 10.1016/j.preghy.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
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10
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Yu J, Pudwell J, Dayan N, Smith GN. Postpartum Breastfeeding and Cardiovascular Risk Assessment in Women Following Pregnancy Complications. J Womens Health (Larchmt) 2020; 29:627-635. [DOI: 10.1089/jwh.2019.7894] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julie Yu
- Department of Obstetrics and Gynecology, Kingston Health Sciences Center, Queen's University, Kingston, Canada
| | - Jessica Pudwell
- Department of Obstetrics and Gynecology, Kingston Health Sciences Center, Queen's University, Kingston, Canada
| | - Natalie Dayan
- Department of Medicine, McGill University, Montreal, Canada
| | - Graeme N. Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Center, Queen's University, Kingston, Canada
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11
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Countouris ME, Holzman C, Althouse AD, Snyder GG, Barinas-Mitchell E, Reis SE, Catov JM. Lactation and Maternal Subclinical Atherosclerosis Among Women With and Without a History of Hypertensive Disorders of Pregnancy. J Womens Health (Larchmt) 2020; 29:789-798. [PMID: 31895649 DOI: 10.1089/jwh.2019.7863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: We evaluated subclinical cardiovascular disease in relation to lactation history among women with normotensive pregnancies and women with hypertensive pregnancies, a distinction not previously examined. Materials and Methods: The POUCHmoms study included 678 women from a pregnancy cohort who were followed 7-15 years after delivery. We measured blood pressure, lipid levels, carotid intima-media thickness (CIMT), and lactation duration for each live birth (LB) at follow-up. We categorized lactation as never, <6 months/LB, or ≥6 months/LB. We analyzed associations between lactation and cardiometabolic risk factors and CIMT by using analysis of variance and multivariable linear regression (adjusted for age, race, socioeconomic status, smoking, time from last pregnancy, and total parity), which produced adjusted least square mean differences (LSMdiff) between groups. Results: In the normotensive pregnancies group with women who never lactated as the referent (n = 157): Women with some lactation but <6 months/LB (n = 284) had higher high density lipoprotein (HDL) (LSMdiff = +4.47 mg/dL, p = 0.013), lower triglycerides (LSMdiff = -38.1 mg/dL, p = 0.02), and thinner mean CIMT (LSMdiff = -0.03 mm, p = 0.005); women who lactated for ≥6 months/LB (n = 133) also had higher HDL (LSMdiff = +7.59 mg/dL, p < 0.001), lower triglycerides (LSMdiff = -41.6 mg/dL, p = 0.01), and thinner mean CIMT (LSMdiff = -0.03 mm, p = 0.003). After further adjustment for body mass index, associations between lactation and HDL, triglycerides, and mean CIMT persisted. These associations were not detected in women with prior hypertensive pregnancies. Conclusions: Women with a history of normotensive pregnancies and lactation for any duration had a more favorable cardiometabolic profile and were at decreased risk of subclinical atherosclerosis compared with those who never lactated.
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Affiliation(s)
- Malamo E Countouris
- Department of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Andrew D Althouse
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gabrielle G Snyder
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Emma Barinas-Mitchell
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven E Reis
- Department of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Janet M Catov
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
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12
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Groer M, Louis-Jacques A, Szalacha L, Redwine L, Dracxler R, Keefe D. Relationship of Anxiety, Inflammation, and Telomere Length in Postpartum Women: A Pilot Study. Biol Res Nurs 2019; 22:256-262. [PMID: 31858822 DOI: 10.1177/1099800419890424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The postpartum period can be a vulnerable time during which many women are prone to mood disturbances. Since telomere length (TL) is known to be associated with dysphoric moods, inflammation, and stress in many populations, this study's objective was to assess the relationships among TL, dysphoric moods, stress, and inflammation during the postpartum period. METHOD This cross-sectional pilot study is a secondary analysis of data collected in a larger parent study of anti-thyroid peroxidase (TPO) enzyme antibody positive versus negative women. The parent study followed selected mothers every month for 6 postpartum months. From this parent study, a random sample of preserved peripheral blood mononuclear cells from 97 participants collected at 2-4 months postpartum were measured for TL. Data were available on the production of interleukin-6 (IL-6), an inflammatory cytokine, in stimulated ex vivo cultures for 59 of these women. Dysphoric moods and stress were measured. Pearson correlations and linear regressions were performed, controlling for postpartum thyroiditis status and age. RESULTS There were no statistically significant relationships between TL and demographic factors, stress, depression, or TPO status. There were significant negative correlations between TL and anxiety and a trend for a relationship between TL and IL-6 levels. IL-6 levels were significantly, positively associated with negative moods. CONCLUSIONS Higher anxiety scores and inflammation were associated with shorter TL. Inflammation was related to anxiety and other dysphoric moods and was marginally associated with shorter TLs.
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Affiliation(s)
- Maureen Groer
- University of South Florida College of Nursing, Tampa, FL, USA
| | | | - Laura Szalacha
- University of South Florida College of Nursing, Tampa, FL, USA
| | - Laura Redwine
- University of South Florida College of Nursing, Tampa, FL, USA
| | - Roberta Dracxler
- Department of Obstetrics and Gynecology, NYU Langone Medical Center, NY, USA
| | - David Keefe
- Department of Obstetrics and Gynecology, NYU Langone Medical Center, NY, USA
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13
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Breastfeeding and maternal cardiovascular risk factors: 1982 Pelotas Birth Cohort. Sci Rep 2019; 9:13092. [PMID: 31511590 PMCID: PMC6739402 DOI: 10.1038/s41598-019-49576-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/23/2019] [Indexed: 01/09/2023] Open
Abstract
This study evaluated the association of breastfeeding duration with maternal metabolic cardiovascular risk factors among women who have been prospectively followed since birth in a southern Brazilian city. In the unadjusted analysis, total cholesterol was higher among women who never breastfed in relation to those who breastfed ≥12 months. Among women with one livebirth, a shorter duration of breastfeeding was associated with lower HDL, while those with two or more livebirths and that breastfed for shorter time presented lower pulse wave velocity, glycaemia and non-HDL measures. After controlling for confounding variables, the magnitude of these associations decreased, and the confidence intervals included the reference. Concerning the duration of breastfeeding of the last child, the analysis was stratified by time since last birth. After controlling for confounders, systolic blood pressure was lower among women who breastfed 3 to <6 months and had a child within the last five years in relation to those who breastfed ≥6, but no clear trend was observed (p = 0.17). In conclusion, our findings suggest that there is no association between lactation and maternal cardiometabolic risk factors.
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14
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Mertens * K, Muys * J, Jacquemyn * Y. Postpartum C-Reactive Protein: A limited value to detect infection or inflammation. Facts Views Vis Obgyn 2019; 11:243-250. [PMID: 32082531 PMCID: PMC7020948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND During pregnancy the maternal immune system adjusts to preserve the foetoplacental unit. These adjustments lead to an increase in CRP, continuing into the postpartum. The objective of this study was to determineantepartal, peripartal and postpartal factors associated with an elevated CRP on the second postpartum day. METHODS A retrospective quantitative, monocentric file analysis in which antepartal, peripartal and postpartal factors were collected from a convenience sample was performed. On the second day postpartum CRP was taken according to local protocol. Uni- and multi-variate analysis was performed to determine factors that are related to postpartum level of CRP. The total sample size consisted of 1400 patients. RESULTS Multiple regression analysis indicated 11 factors related to increased CRP on the second day postpartum: gestational age (p=0.002), maternal blood leukocyte count on day 2 postpartum (p<0.001), artificial rupture of the membranes (p<0.001), fever during labor (p<0.001), indwelling urinary catheter (p=0.008), epidural anesthesia (p<0.001), fetal scalp electrode (p<0.001), primary planned caesarean (p=0.019), secondary caesarean h (p<0.001), formula feeding (p=0.030) and fever during postpartum (p=0.001). CONCLUSION This research indicates that many antepartal, peripartal and postpartal factors are related to high postpartum CRP. CRP can not be used as a screening test test in the postpartum to discriminate between normal and pathologic inflammatory/infectious changes.
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Affiliation(s)
- K Mertens *
- Department of Obstetrics, KLINA Hospital, Brasschaat, Belgium
| | - J Muys *
- Department of Obstetrics and Gynaecology, Antwerp University UA ASTARC and Antwerp University Hospital UZA, Edegem, Belgium
| | - Y Jacquemyn *
- Department of Obstetrics and Gynaecology, Antwerp University UA ASTARC and Antwerp University Hospital UZA, Edegem, Belgium;,Department of Global Health, Antwerp University UA, Edegem, Belgium
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15
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Havens JME, Wines M. Screening for Mothers at Risk to Wean Early and Referral to a Lactation Support Person for Prolonging Breastfeeding. J Perinat Educ 2019; 28:51-60. [PMID: 31086475 DOI: 10.1891/1058-1243.28.1.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This project trialed the breastfeeding control (BFC) scale of the Breastfeeding Attrition Prediction Tool (BAPT) to identify mothers at high risk to wean early and to determine the effectiveness of a prenatal consult with a lactation support person on breastfeeding duration and intensity. Results indicated that mothers with lower scores on the BAPT-BFC scale showed a trend for decreased breastfeeding intensity at 8 weeks postpartum. Experimental and control groups had similar BAPT-BFC scores and breastfeeding intensity at 8 weeks. Overall, women who had low BAPT-BFC scores tended to be breastfeeding less at 8 weeks compared with mothers who scored very high. This finding would suggest the BAPT-BFC is a helpful tool for predicting breastfeeding success.
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16
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Lima NP, Bassani DG, Silva BGCD, Motta JVS, Magalhães EIS, Barros FC, Horta BL. Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age. CAD SAUDE PUBLICA 2019; 35:e00122018. [PMID: 30785489 DOI: 10.1590/0102-311x00122018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/10/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed at assessing the association of breastfeeding with maternal body mass index (BMI), waist circumference, fat mass index, fat free mass index, android/gynoid fat ratio and bone mineral density. In 1982, the maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were daily visited and all live births were identified and examined. These subjects underwent follow-up for several times. At 30 years of age, the participants were interviewed and examined. Parous women provided information on parity and duration of breastfeeding. Multiple linear regression was used in the multivariate analysis, controlling for genomic ancestry, family income, schooling and smoking at 2004-2005. After controlling for confounding factors, breastfeeding was inversely associated with BMI and fat mass index, whereas breastfeeding per live birth was negatively associated with BMI, waist circumference and fat mass index. Women who had had a child in the last 5 years and had breastfed, showed lower BMI (β = -2.12, 95%CI: -4.2; -0.1), waist circumference (β = -4.46, 95%CI: -8.3; -0.6) and fat mass index (β = -1.79, 95%CI: -3.3; -0.3), whereas no association was observed among those whose last childbirth was > 5 years, but the p-value for the tests of interaction were > 0.05. Our findings suggest that breastfeeding is associated with lower BMI and other adiposity measures, mostly in the first years after delivery. Besides that, it has no negative impact on bone mineral density.
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Affiliation(s)
- Natália Peixoto Lima
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Diego G Bassani
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Bruna G C da Silva
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Janaína V S Motta
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Elma Izze S Magalhães
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Fernando C Barros
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Bernardo L Horta
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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17
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Countouris ME, Demirci JR, Jeyabalan A, Catov JM, Schwarz EB. Relationship of Postpartum Levels of Cystatin and High-Sensitivity C-Reactive Protein and Duration of Lactation in Mothers with Previous Gestational Hypertension or Preeclampsia. Breastfeed Med 2019; 14:408-415. [PMID: 30874448 PMCID: PMC6648190 DOI: 10.1089/bfm.2018.0153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Women with hypertensive disorders of pregnancy are at increased risk of cardiovascular disease in later life. We sought to determine the association between lactation and markers of maternal cardiovascular health among postpartum women with and without hypertensive disorders of pregnancy via measures of inflammation (high-sensitivity C-reactive protein [hsCRP]) and renal function (cystatin C). Materials and Methods: This prospective cohort study enrolled primarily overweight and obese women during early pregnancy. At a postpartum study visit occurring 6-24 months after delivery, we collected data on lactation duration and measured hsCRP and cystatin C. We assessed associations between lactation duration and levels of hsCRP and cystatin C among normotensive women and women with preeclampsia or gestational hypertension using analysis of variance and chi-squared tests. Linear regression models adjusted for age, race, education, prepregnancy body mass index, current smoking, and time since delivery. Results: Of 425 women, 37 (9%) had preeclampsia and 48 (11%) had gestational hypertension during enrollment pregnancy. The postpartum visit occurred at a mean of 8.6 ± 4.4 months after delivery. Women with a history of preeclampsia had significantly higher levels of cystatin C (mean 0.86 versus 0.78 mg/L; p = 0.03) compared with normotensive women, but nonsignificant elevation in hsCRP (mean 8.39 versus 6.04 mg/L; p = 0.08). Women with gestational hypertension had no differences in mean hsCRP or cystatin C compared with normotensive women. Among the 237 women with any lactation, 78 (18%) lactated for at least 6 months. Lactation duration both in the overall sample and among women with gestational hypertension or preeclampsia was not associated with levels of hsCRP or cystatin C. Conclusions: Preeclampsia history was associated with elevated postpartum levels of cystatin C; however, duration of lactation was not associated with postpartum hsCRP or cystatin C, regardless of history of gestational hypertension or preeclampsia. Further research is needed on mechanisms through which lactation may affect maternal risk of cardiovascular disease.
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Affiliation(s)
- Malamo E Countouris
- 1 Department of Cardiology, University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania
| | - Jill R Demirci
- 2 Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
| | - Arun Jeyabalan
- 3 Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Clinical and Translational Sciences Institute, Pittsburgh, Pennsylvania
| | - Janet M Catov
- 4 Department of Obstetrics, Gynecology, and Reproductive Sciences and Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eleanor B Schwarz
- 5 Department of General Internal Medicine, University of California Davis, Sacramento, California
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18
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Bonifacino E, Schwartz EB, Jun H, Wessel CB, Corbelli JA. Effect of Lactation on Maternal Hypertension: A Systematic Review. Breastfeed Med 2018; 13:578-588. [PMID: 30299974 DOI: 10.1089/bfm.2018.0108] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Hypertension is relatively common in pregnancy, and pregnancy may unmask hypertension among women who are predisposed to it. Lactation may be a means through which to mitigate pregnancy-related vascular risk. The impact of lactation on maternal blood pressure, and the duration of any effect, remains unclear. This study aimed at systematically reviewing the literature evaluating the impact of lactation on the development of hypertension. MATERIALS AND METHODS We searched PubMed, including EMBASE and MEDLINE, for studies that reported on the association between breastfeeding and maternal risk of hypertension that were published in a peer-reviewed source. The quality of the studies included was assessed by using the Newcastle-Ottawa Scale. RESULTS Nineteen studies met all inclusion criteria for this review. Of the four studies with short-term follow-up, 50% showed a protective association. The fifteen studies with longer-term follow-up were stratified by outcome assessed. Sixty-seven percent of the studies that evaluated for elevated blood pressure and 100% of the studies evaluating for an outcome of hypertension showed a protective association. The minimum duration of lactation associated with a benefit was 1 month. This association was demonstrated in follow-up periods as long as two to three decades. Studies that showed a protective association had overall higher quality ratings. DISCUSSION Lactation is associated with a beneficial effect on maternal blood pressure that persists for decades. These results add to the growing body of literature demonstrating the protective association of lactation on maternal cardiovascular risk. Providers may incorporate the decreased risk of hypertension into their counseling on the maternal benefits of lactation.
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Affiliation(s)
- Eliana Bonifacino
- 1 Division of General Internal Medicine, Department of Medicine, Montefiore Hospital , Pittsburgh, Pennsylvania
| | - Eleanor B Schwartz
- 2 Division of General Internal Medicine, Department of Medicine, University of California Davis Medical Center , Sacramento, California
| | - Hyejo Jun
- 3 Health Center for Women , Saint Paul, Minnesota
| | - Charles B Wessel
- 4 Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer A Corbelli
- 1 Division of General Internal Medicine, Department of Medicine, Montefiore Hospital , Pittsburgh, Pennsylvania
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Ross KM, Guardino C, Hobel CJ, Dunkel Schetter C. Partner relationship satisfaction, partner conflict, and maternal cardio-metabolic health in the year following the birth of a child. J Behav Med 2018; 41:722-732. [PMID: 29982975 DOI: 10.1007/s10865-018-9947-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/26/2018] [Indexed: 12/11/2022]
Abstract
Intimate partner relationship quality during the child-bearing years has implications for maternal health. The purpose of this study was to test whether partner satisfaction, partner conflict, and their interaction predicted maternal cardio-metabolic health at 12-months postpartum. Women were recruited in 5 U.S. sites. Partner conflict and satisfaction were measured at 6-months postpartum, and cardio-metabolic indicators (blood pressure, waist-hip ratio, glycosylated hemoglobin, total cholesterol:HDL ratio) were assessed at 6- and 12-months. Cardio-metabolic indices were scored continuously (CM risk) and using clinical risk cutoffs (CM scores). A significant conflict-by-satisfaction interaction emerged for the CM risk, b(SE) = .043 (.016), p = .006, and CM scores, b(SE)= .089 (.028), p = .002, such that when partner satisfaction was low, low partner conflict was associated with poorer postpartum cardio-metabolic health. This is the first study to examine close relationships and cardio-metabolic health during the child-bearing years, an issue warranting further attention.
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Affiliation(s)
- Kharah M Ross
- Department of Psychology, University of California, 502 Portola Plaza, Franz Hall 1285, Los Angeles, CA, 90095, USA.
| | - Christine Guardino
- Department of Psychology, University of California, 502 Portola Plaza, Franz Hall 1285, Los Angeles, CA, 90095, USA
| | - Calvin J Hobel
- Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Christine Dunkel Schetter
- Department of Psychology, University of California, 502 Portola Plaza, Franz Hall 1285, Los Angeles, CA, 90095, USA
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20
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Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the Benefits of Lactation for Women's Health. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2018; 40:354-359. [PMID: 29980160 PMCID: PMC10798271 DOI: 10.1055/s-0038-1657766] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/24/2018] [Indexed: 01/28/2023] Open
Abstract
The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should be made to promote, follow and maintain exclusive breastfeeding for up to 6 months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library and Web of Science using the keywords breastfeeding, breast milk, lactation and maternal health.
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Affiliation(s)
- Luiz Antonio Del Ciampo
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), São Paulo, SP, Brazil
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21
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Behairy OG, Fadl AMA, Arafa OS, Fadl AA, Attia MA. Influence of early feeding practices on biomarkers of cardiovascular disease risk in later life. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2017. [DOI: 10.1016/j.epag.2017.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract
OBJECTIVE Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year. METHODS We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum. RESULTS Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index. CONCLUSIONS In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.
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23
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Samways JW, Vause S, Kontopantelis E, Eddleston J, Ingleby S, Roberts A, Clarke B. Maternal heart rate during the first 48h postpartum: a retrospective cross sectional study. Eur J Obstet Gynecol Reprod Biol 2016; 206:41-47. [PMID: 27614270 DOI: 10.1016/j.ejogrb.2016.08.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/26/2016] [Accepted: 08/19/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES 1) Describe the distribution of heart rate in the first 48h postpartum in women with no evidence of sepsis, anaemia or haemorrhage. 2) Investigate the relationship between postpartum heart rate and other maternal factors. STUDY DESIGN A retrospective cross-sectional study of postpartum women who delivered between July 2012 and June 2015 in a tertiary hospital. Data was analysed from the local maternity system and electronic vital signs database. The main outcome measures: Heart rate at 6, 12, 24 and 48h postpartum. RESULTS Data were obtained on 11401 women. After exclusion of women with possible sepsis, anaemia or haemorrhage, 7627 heart rate readings from 5164 women were analysed. Mean heart rate (+2SD/+3SD) at 6h was 83.6 (108.2/120.6), 12h 84.5 (109.4/121.9), 24h 85.4 (110.4/122.9), and 48h 84.3 (109.7/122.4). There was statistical correlation of post partum heart rate with body mass index (BMI), age and discharge haemoglobin. CONCLUSION This study describes the distribution of maternal heart rate in the early postpartum period, in women with no evidence of sepsis, anaemia or major haemorrhage. This will facilitate identification and appropriate investigation of women with abnormal heart rates. Although correlation with BMI, age and discharge haemoglobin was demonstrated, the differences were small and not clinically meaningful. Further work investigating the relationship between postpartum heart rate and poor maternal outcomes is required.
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Affiliation(s)
- Jack W Samways
- University of Manchester, Oxford Road, Manchester M13 9PT, United Kingdom.
| | - Sarah Vause
- St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust Hospital, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Evangelos Kontopantelis
- Centre for Primary Care, Institute of Population Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Jane Eddleston
- Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Sarah Ingleby
- Old School of Physiotherapy Annexe, Central Manchester University Hospitals NHS Foundation Trust Hospital, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Anna Roberts
- St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust Hospital, Oxford Road, Manchester M13 9WL, United Kingdom
| | - Bernard Clarke
- Institute of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, United Kingdom; Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom
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24
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Effects of lactation on postpartum blood pressure among women with gestational hypertension and preeclampsia. Am J Obstet Gynecol 2016; 215:241.e1-8. [PMID: 26945604 DOI: 10.1016/j.ajog.2016.02.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/18/2016] [Accepted: 02/24/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Women with a history of hypertensive disorders of pregnancy are at an increased risk of hypertension and cardiovascular disease in later life. Lactation has been associated with a reduced risk of maternal hypertension, both in the postpartum period and later life. However, little is known about whether lactation is also cardioprotective in women with hypertensive disorders of pregnancy such as preeclampsia or gestational hypertension. OBJECTIVE This study aimed to characterize the relationship between lactation and postpartum blood pressure among women with preeclampsia and gestational hypertension. STUDY DESIGN Data were obtained from women who participated in the Prenatal Exposures and Preeclampsia Prevention study (n = 379; 66% African American; 85% overweight or obese). Women enrolled during pregnancy and attended a postpartum visit (on average, 9.1 months after delivery) during which data on lactation duration and blood pressure were collected. The significance of the associations between postpartum blood pressure and lactation among women who remained normotensive during pregnancy, developed gestational hypertension, or developed preeclampsia were assessed with an analysis of variance. Linear regression models were used to adjust for maternal age, race, education, prepregnancy weight, and time since delivery. RESULTS Gestational hypertension affected 42 subjects (11%) and preeclampsia affected 33 (9%). Lactation was reported by 217 (57%) with 78 (21%) reporting ≥ 6 months of lactation. Women who lactated were somewhat older, more educated, and had higher socioeconomic status. Among women who had gestational hypertension, lactation was associated with lower systolic blood pressure (P = .02) and diastolic blood pressure (P = .02). This association persisted after adjustment for age, race, education, prepregnancy weight, and time since delivery. However, for women who had preeclampsia and women who remained normotensive during pregnancy, lactation was not associated with postpartum blood pressure in either bivariate or multivariate analyses. CONCLUSION This study found that lactation is associated with lower postpartum blood pressure among overweight women who develop gestational hypertension but not among women who develop preeclampsia. Future studies are needed to explore the association of lactation and blood pressure in later life for women with hypertensive disorders of pregnancy.
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Abstract
Researchers hypothesize that pregnancy and lactation are part of a continuum, with lactation meant to "reset" the adverse metabolic profile that develops as a part of normal pregnancy, and that when lactation does not occur, women maintain an elevated risk of cardio-metabolic diseases. Several large prospective and retrospective studies, mostly from the United States and other industrialized countries, have examined the associations between lactation and cardio-metabolic outcomes. Less evidence exists regarding an association of lactation with maternal postpartum weight status and dyslipidemia, whereas more evidence exists for an association with diabetes, hypertension, and subclinical and clinical cardiovascular disease.
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Affiliation(s)
- Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia 30341;
| | - Jennifer M Nelson
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia 30341;
| | - Jennifer Corbelli
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
| | - Kelley S Scanlon
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia 30341;
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Hugon-Rodin J, Plu-Bureau G. [Hypertension and pregnancy: Post-partum period]. Presse Med 2016; 45:651-8. [PMID: 27229451 DOI: 10.1016/j.lpm.2016.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 04/19/2016] [Indexed: 01/04/2023] Open
Abstract
Post-partum period is associated with specific characteristics in women with gestational disorders or preeclampsia. For breastfeeding women, the choice of antihypertensive treatment should take into account the impact on child health. The impact of breastfeeding on health mother must be also discussed. Moreover, for lactation inhibition, bromocriptine should not be used, especially in the context of gestational disorders. In post-partum period, the best contraceptive strategy is only-progestin contraception or non-hormonal contraceptives use. However, this choice will depend on the stabilization or normalization of blood pressure in early post-partum period. Finally, several consultations should be suggested: an information and announcement to explain the consequences of these gestational disorders and organize their multidisciplinary management and follow-up. A preconceptional consultation takes its place to anticipate potential recurrent preeclampsia or gestational hypertension and to schedule a future pregnancy in optimal conditions.
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Affiliation(s)
- Justine Hugon-Rodin
- Hôpital Port-Royal, unité de gynécologie médicale, 53, avenue de l'observatoire, 75014 Paris, France
| | - Geneviève Plu-Bureau
- Hôpital Port-Royal, unité de gynécologie médicale, 53, avenue de l'observatoire, 75014 Paris, France.
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Schwarz EB. Invited Commentary: Breastfeeding and Maternal Cardiovascular Health--Weighing the Evidence. Am J Epidemiol 2015; 181:940-3. [PMID: 25944888 DOI: 10.1093/aje/kwv029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/13/2015] [Indexed: 01/13/2023] Open
Abstract
Recently, there has been growing interest in understanding the ways in which lactation affects maternal health. The accompanying article by Palmer et al. (Am J Epidemiol. 2015;181(12):932-939), particularly their finding that prepregnancy obesity modifies the relationship between lactation and postpartum weight gain, makes an important contribution to this field. In this commentary, I discuss these findings within the context of other recent literature which indicates that whether or not a mother breastfeeds her newborn appears to be a powerful predictor of the mother's future risk of developing diabetes, hypertension, and cardiovascular disease, independent of maternal weight or body mass index in later life.
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Abstract
Cardiovascular disease is a leading cause of death of women around the world. Diet, exercise, smoking cessation, and blood pressure control are all recognized as key elements of preventing cardiovascular disease. Infant feeding has received less attention, but the studies reviewed here indicate that lactation may also play an important role in determining women's future risk of heart disease. A growing body of literature indicates that mothers who prematurely discontinue lactation face increased risk of visceral adiposity, hypertension, hyperlipidemia, diabetes, and subclinical cardiovascular disease, as well as cardiovascular morbidity and mortality. Breastfeeding is not always easy, but neither is dieting, exercise, smoking cessation, or treating hypertension. In order to effectively fight heart disease, efforts are needed to promote all aspects of a healthy lifestyle, which for women includes breastfeeding their babies.
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Affiliation(s)
- Eleanor Bimla Schwarz
- Director, Women's Health Services Research Unit, Center for Research on Health Care; and Associate Professor of Medicine, Epidemiology, Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh , Pittsburgh, Pennsylvania
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